肝动脉灌注化疗栓塞联合微波消融治疗中晚期肝癌的疗效观察

目的:探讨肝动脉灌注化疗栓塞(TACE)序贯微波固化消融术(PMCT)治疗中晚期肝癌的临床疗效及应用价值。方法:选取不能手术切除的原发性中晚期肝癌患者87例,单纯行TACE治疗的57例患者作为对照组,行TACE序贯PMCT治疗的30例患者作为实验组,比较两组总有效率、甲胎蛋白(AFP)平均下降率、生存率、复发转移率及毒副反应。结果:实验组和对照组的总有效率分别为70.00%、45.61%,治疗后AFP平均下降率分别为87.5%、50.0%,0.5、1、1.5、2年累积生存率分别为100%、95%、81%、59%和93%、79%、67%、28%,0.5、1、2年累积复发转移率分别为8.15%、19.21%、36.17%和8.34%、38.94%、61.35%,各项指标差异均有统计学意义(P<0.05～0.01);两组毒副反应相似。结论:TACE序贯PMCT治疗中晚期肝癌安全、有效、可行,临床疗效优于单纯TACE治疗,可提高患者生存期,降低复发转移率,不增加毒副反应。

Efficiency of transcatheter hepatic arterial chemoembolization combined with microwave ablation in patients with advanced liver cancer

Objective: To retrospectively analyze the clinical therapeutic effect and application value of transcatheter hepatic arterial chemoembolization(TACE) combined with percutaneous microwave coagulation therapy(PMCT) on advanced liver cancer.Methods:A total of 87 cases of advanced liver cancer that were not suitable for radical resection were selected retrospectively,of which 57 cases that underwent TACE alone were assigned as control group,the other 30 cases treated with TACE+PMCT were assigned as the treatment group.Then recent clinical effect,reduced rates of AFP,survival rate,incidences of recurrence and metastasis,as well as side effects of the two groups were compared.Results: The total efficiency of the treatment group and control group were 70.00%(21/30) and 45.61%(26/57);after treatment reduced rate of AFP were 87.5%(21/24) and 50.0%(22/44);6 months,1 year,1.5 years,2 years-cumulative survival rates were 100%,95%,81%,59% vs.93%,79%,67%,28%;6 months,1 year 2-year cumulative recurrence rate were 8.15%,19.21%,36.17% vs.8.34%,38.94%,61.35%,showing significant differences in all the indexes(P<0.05~0.01).Side effects were similar in both groups.Conclusion: The TACE+PMCT is a effective,safe,and feasible treatment for advanced liver cancer,which shows better effects than that of TACE alone,and can raise patients survival rate,reduce recurrence rate without increasing side effects.